Disability-adjusted Life Years for Diabetes in Cuban Children and Adolescents, 1990-2010

INTRODUCTION Shifts in diabetes onset to earlier ages, globally and in Cuba, signify greater risk of early complications and premature death, with consequent economic and social repercussions for families and health systems. OBJECTIVE Describe the trend in diabetes burden in Cuban children and adolescents in the period 1990 to 2010, in terms of disability-adjusted life years. METHODS A descriptive epidemiological study was conducted of diabetes burden in Cuba, analyzing the years 1990, 1995, 2000, 2005 and 2010 for the age group 0-19 years. Disability-adjusted life years were obtained from the sum of potential years of life lost plus years lived with disability. The first is calculated based on total deaths in the country in which diabetes was recorded as underlying cause; the second from the product of severity, as assigned to diabetes in similar studies, and incidence and average duration, provided by the DISMOD II program, which estimates six internally consistent epidemiological indicators. RESULTS Mortality indicators improved, with a decrease in the rate of potential years of life lost in boys from 21.9/100,000 population in 1990 to 0 in 2010, and in girls from 38.8/100,000 in 1990 to 4.9/100,000 in 2010 (1% of disability-adjusted life years in girls in 2010, corresponding to one death). In contrast, years lived with disability increased by 134.5% in boys and 156.4% in girls. The net result was that disability-adjusted life years increased by >100% in both sexes (from 137.2 to 321.9/100,000 in boys and from 157.3 to 403.3/100,000 in girls, increases of 102.3% and 108.1%, respectively). CONCLUSIONS Disability-adjusted life years lost for diabetes in Cuban children and adolescents have increased, due to disability, while mortality has decreased. KEYWORDS Diabetes mellitus, childhood, adolescence, disability-adjusted life years, potential years of life lost, years lived with disability, Cuba.